Healthcare Provider Details

I. General information

NPI: 1275130163
Provider Name (Legal Business Name): JESSICA E. HIERS AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CORRALES RD NW STE I
ALBUQUERQUE NM
87114-9255
US

IV. Provider business mailing address

10700 CORRALES RD NW STE I
ALBUQUERQUE NM
87114-9255
US

V. Phone/Fax

Practice location:
  • Phone: 505-890-0003
  • Fax:
Mailing address:
  • Phone: 505-890-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberSAH-2025-0190
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: